Spot the sign of stroke

Now doctors say a bystander can recognize a stroke by asking three simple questions:

S * Ask the individual to SMILE.

T * Ask the person to TALK to SPEAK A SIMPLE SENTENCE(Coherently) (i.e. It is sunny out today)

R * Ask him or her to RAISE BOTH ARMS.

NOTE: Another ’sign’ of a stroke is this: Ask the person to ’stick’ out their tongue. If the tongue is ‘crooked’, if it goes to one side or the other that is also an indication of a stroke. If he or she has trouble with ANY ONE of these tasks, call 999 immediately !! and describe the symptoms to the dispatcher.

A cardiologist says if everyone who gets this e-mail sends it to 10 people; you can bet that at least one life will be saved.

Sources above: Mr. Lim Kit Siang's blog

Ask the pharmacist!
Usually a stroke patient will experience

1) Weakness: paresthesia(numbness, prickly, stinging, or burning feeling); loss of sensation in face, arm, or leg.
2) Loss of speech
3) Loss of vision in one eye or in one visual field
4) Vertigo, with dysarthria(impairment or clumsiness in the uttering of words), diplopia (2 images of an object seen at the same time or double vision), imbalance.

Want to know your 10 year risk of stroke?
Let me know your age, your systolic blood pressure, also your systolic BP if you are on medication, smoking or not, any history of atrial fibrillation, any diagnosis of left ventricular hypertrophy, and history of heart attack and are you a diabetic?
Then i can calculate your risk of stroke based on Am Heart J 1991;83:356-362 Statement for health professional!!

Diarrhea

How does your stools looks like?
According to Wikipedia, Type 1 and Type 2 indicates constipation, 3 and 4 are the easiest to pass and types 5-6 are the more symptomatic of diarrhea, while type 7 may be a sign of cholera, food poisoning, etc.

If you are having type 7 stools?
Sign and symptoms
Loose liquid stools +/- blood or mucus, fever, abdominal pain and distension, headache, anorexia, malaise, vomiting, myalgia, cramping.

Treatment
Oral Rehydration Salt: The main treatment.
Loperamide: 4mg followed by 2mg capsule after each unformed stool
Diphenoxylate/Atropine: 2.5mg/25ug every 4 hours until symptoms resolved.

If the pathogens identified (after consulting your doctor or pharmacist)
Giardia: Metronidazole 250mg tds for 5 days.
E.histolytica: Metronidazole 750mg tds for 10 days.
Shigella: Trimethoprim-sulfamethoxazole 160mg and 800mg 2bd for 5 days, or Ciprofloxacin 500mg bid for 3 days.
C.difficile (associated with antibiotic uses): Metronidazole 500mg tds for 10-14days.
Travellers diarrhea: Ciprofloxacin 750mg one dose or, if severe 500mg bid for 3 days.

Ask the pharmacist!
1)If you are given antibiotic by your doctor, make sure you ask for what type of antibiotic you are taking.
2)If you are given antibiotics others than above, maybe you can ask what is your actual diagnosis.
3)Photosensitivity is the common side effect when taking above antibiotics, so you may need to reduce your sun exposure during treatment.
4)Let the pharmacist know what other medication you are taking, eg. Ciprofloxacin increase theophylline levels and cost toxicity.
5)There is no evidence that bowel rest speeds recovery, and food may enhance the efficacy of oral rehydration therapy. I would encourage you to follow your normal diet or this (dry toast or bread, baked potato, chicken soup with rice or noodles, poultry, bananas) but you still need to avoid coffee, alcohol, diary products, most fruits, vegetables, red meats, and heavily seasoned foods.
6) Taking probiotics can reduce the duration of acute infectious diarrhea (Systemic review of 23 randomized trials of probiotics in 1,917 patients with acute diarrhea; probiotics reduced risk of diarrhea at 3 days(15 trials) and mean duration of diarrhea by 30.5 hours (12 trials)
7) Taking zinc supplementation at 3x RDA reduce duration of diarrhea (Pediatrics 2002 May;109(5):898), reduced diarrheal duration and volume (J Paediatr Gastroenteral Nutr), and reduce morbidity and mortality(BMJ 2002 Nov 9;325(7372):1059)

Blood Glucose Monitor : AccuCheck Advantage III vs OneTouch Ultra

Comparing 2 of the best selling and most well known blood glucose monitoring system available in Malaysia.

	One Touch Ultra	AccuCheck Advantage III
Accuracy	Proven 99.2%	Accurate
Alternate site	Yes (Fingertip or forearm)	Yes( Capillary, venous,arterial and neonate)
Blood volume	1uL	4uL
Result test time	5seconds	30 seconds
Measurement range	1.1-33.3mmol/L	0.6-33.3 mmol/L
Variability	<3.2%	<3.5%
Memory	150 readings (14,30 days averages)	480 readings (7,14,30 days averages)
Battery life	1000 tests. Auto off after 2minutes	Not stated. Auto off after 90sec
Strips shelf life	3 months from the date of opening	Not stated.
Operating Ranges	Temp: 6-44C,10-90% humidity	Temp: 14-40C, <85%humidity
Quality control	Control solution supplied	Not supplied.
Reference Manual	English +Chinese manual	English only
Lancets	Needle (cheaper generic available)	Original needle.
Result affected	Hematocrit level	Hematocrit levels
Can do test in high altitude?	up to 3048 meters	up to 3093.72 meters
Interference?	Acetaminophen, salicylates, uric acid, ascorbic acid (high conc will cause inaccurately high results	Galactose or Maltose (via IV)present in blood, peritoneal dialysis using solutions containing Icodextrin
	Oxygen therapy yield falsely low result
	Severe dehydrated, in shock, in hyperosmolar state	Severe dehydrated, in shock, in hyperosmolar state, hypotension, severe congestive heart failure, or peripheral vascular disease
Warranty	Life time. One to one replacement	Life time. Transferable to next of kin.
Meter Storage	2 to 32 C	-25 to 70 C
Awards?	No 1 meter recommended by Diabetes Specialist in US	Best Selling Brand in Malaysia
Toll Free Line	1800-801497 (Mon-Fri: 8.30am-5pm)	1800-88-1313
Member rewards	None	8 boxes of 25 strips free 2 boxes of 10 strips (2007)
Machine cost	RM 375 (before discount)	RM 380 (before discount)
Strips cost	RM 1.85-2.00	RM 1.75-1.90
Lancets cost	RM 0.375 (Generic=RM 0.15)	RM 0.40 (No generic)

Ask the pharmacist!
Operation cost is almost comparable. So, there is no clear winner here. But if u want to save cost, AccuCheck Advantage III may prove to be cheaper option (because of the members reward offers) and wide availability in everywhere.
If you are afraid of pain, then One Touch Ultra maybe better choice since it use smaller blood sample, thus less pain when pricking and also you can even choose to prick your forearm.

Want to get one Blood Glucose Monitoring System?
Pharmalogik also having a one to one exchange with a brand new life time warranty blood glucose machine. Tired with your old machine? Feels u want to have a change? Trade it in!!!
Email me. pharmalogik@gmail.com

My car accident in 2005

Would you buy a Proton Iswara? What happens when they meet head to back?
This actually happened to me some where in 2005, months before pharmalogik opens. Out of nowhere, suddenly the car banged my car from behind. It also turn out the car driver work as an ambulance driver in my district hospital.
Right after the accident, the Kurnia Insurance towing car arrived within minutes.
There he goes...
The result: How about my car?
Would you buy a Proton Iswara/ Saga? Yes and No. Proton Saga/ Iswara is soft in front and super hard at the back. Still i have changed a new bumper. It cost me RM 400 as the guy does not have insurance cover.

Ask the pharmacist!
So next time accident...it is better to get hit from the back than the front when you are driving malaysian car and it is much better to be hit by a better car (as usually imported car has insurance to cover)

I am getting married!!!

7/07/07
Registration of marriage in Tadika Cher Fong Khor, Teluk Intan.

8/07/07
8.30am
"Heng Tai" gather in my father's shop

9.00am
Going to the bride house to "steal" the bride

6.00pm
Dinner at Restaurant Tai Chong, Teluk Intan
(For those with GPS: N 04 00.950', E101 01.798')

Me and my wife!!!